NPIMap

Organization Active NPI

Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Mount Pleasant, SC
National Provider Identifier
1104914076
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PAIN MANAGEMENT, LLC
Practice address
1092 Johnnie Dodds Blvd
Suite A2 Left
Mt Pleasant, SC 29464-6109
Phone
(843) 388-6552
NPI assigned
Oct 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bernice K Richardson
Title
Medical Affairs Manager
Phone
(803) 254-2394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

1092 Johnnie Dodds Blvd
Suite A2 Left
Mt Pleasant, SC 29464-6109

Mailing address

PO Box 2344
Columbia, SC 29202-2344
Phone (803) 254-2394

National Provider Directory

National Provider Directory

Locations

1092 Johnnie Dodds Blvd
Ste A2
Mt Pleasant, SC 29464
Phone (561) 542-4927

Practitioners & affiliated clinicians

Practitioners 176

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 176

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104914076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2344",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292022344",
            "telephone_number": "803-254-2394",
            "fax_number": "803-254-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 JOHNNIE DODDS BLVD",
            "address_2": "SUITE A2 LEFT",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294646109",
            "telephone_number": "843-388-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL AFFAIRS MANAGER",
        "authorized_official_telephone_number": "803-254-2394"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.